高度损伤的延迟期计算机断层扫描:增加了没有改善结果的干预措施,以及随访时症状的预测值
William Rice1, Ryan Mancoll, Stephanie Harper
1From the Division of Acute Care Surgery, Department of Surgery (W.R., R.M., S.H., J.H., P.A., J.C.), Eastern Virginia Medical School, Old Dominion University, Norfolk, Virginia.
The journal of trauma and acute care surgery
|January 27, 2026
概括
高度损伤的延迟相计算断层扫描 (DPCT) 与更多的泌尿外科干预有关,但并没有重大并发症. 无症状患者在随访DPCT时没有表现出尿道扩散.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 放射学 放射学是一门学科.
- 创伤外科 手术 创伤外科
背景情况:
- 使用延迟相计算断层扫描 (DPCT) 在高度损伤中查尿道外流是常见的.
- DPCT与泌尿外科干预率的增加有关.
- 在随访DPCT时尿道扩散的临床症状的预测价值需要进一步调查.
研究的目的:
- 调查DPCT与尿道干预率和高度损伤患者的主要并发症之间的关联.
- 在随访DPCT时分析尿道扩散的临床症状的预测价值.
主要方法:
- 从2013年至2023年,对234名患者 (III-V级损伤) 进行了回顾性队列研究.
- 分析机构创伤登记和电子医疗记录.
- 单变量和多变量回归以评估DPCT与并发症和干预措施的关联;对症状的预测价值进行子组分析.
主要成果:
- 101名患者 (43.2%) 接受了DPCT;基线特征在各组之间相似.
- DPCT与更高的泌尿干预率 (21.8%与2.3%,p < 0.001) 相关,但主要并发症率相似 (16.8%与16.5%,p = 0.95).
- DPCT与重大并发症无关 (OR 1.49,p=0.33),但与泌尿学干预有很大关系 (OR 15.22,p<0.001);症状具有100%的敏感性和NPV扩散.
结论:
- DPCT与泌尿外流的泌尿干预强烈相关,但并不是主要的并发症.
- 无症状患者始终有负面的随访DPCT,表明潜在的过度治疗.
- 需要进一步的前性研究来证实由于单个中心的回顾性限制而导致的发现.
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